Captopril inhibits the production of tumor necrosis factor-alpha by human mononuclear cells in patients with congestive heart failure

To study the effects of captopril on tumor necrosis factor-alpha produced b y peripheral blood mononuclear cells (PBMC) of patients with congestive hea rt failure (CHF), we determined the TNF-alpha concentrations of culture sup ernatants: of PBMC with and without catopril in 74 CHF patients with variou s heart diseases. The results showed that the supernatants concentrations o f TNF-alpha in cultured PBMC (PBMC-TNF-alpha) were significantly increased in non-cachetic and cachetic CHF patients. and even higher in cachetic CHF patients, as compared with the controls (i.e.. patients with New York Heart Association CHF classification I). The PBMC-TNF-alpha was significantly in hibited by captopril. These results demonstrate that the expression of TNF- alpha. in PBMC is increased and can be inhibited hy captopril in patients w ith CHF. especially in those accompanied by cachexia. This suggests that th e immunomodulatory effects of captopril may contribute to its beneficial ef fects in heart failure patients. (C) 2001 Elsevier Science B.V. All rights reserved.